Who follows up patients after PEG tube insertion?

Community follow-up is often inadequate for patients discharged from hospital following commencement of PEG tube feeding.

We performed a postal questionnaire to assess if patients/carers were trained in the care of the PEG tube pre-discharge and whether appropriate community follow-up was in place.

Of 166 PEG tubes inserted during the study period, 66 patients were alive at least 6 months following PEG tube insertion. Response rate was 44% (29 of 66 patients). Of the 29 respondents, 21 (72%) had been taught how to manage the tube, feeds and feeding pumps prior to discharge; 17 (59%) had their swallow re-assessed following PEG tube insertion and 16 (55%) patients were able to take some food or liquids by mouth. Twenty-four (83%) patients had had dietetic assessment following discharge. Fifteen patients had encountered problems with the PEG tube, 14 of whom knew who to contact in the event of a problem, all of which were resolved. In six of the 14 cases the respondent felt that the experience was not satisfactory for the patient/carer and that the resolution of PEG-related problems could be improved. In 9 (31%) cases the PEG tube had been removed.

Over two-thirds of patients/carers had been trained regarding PEG tube care. As expected, dietetic follow-up was in place for the majority of patients. Approximately one third of patients had had their PEG tube removed. Ongoing PEG tube feeding may not be required in all of the remaining patients. Most PEG tube problems were resolved although there is still scope to improve the PEG follow-up service.